Amenorrea primaria-galactorrea asociada a hiperpro, lactinemia con síndrome de silla turca vacia primario

RESUMEN

Objetivo: Presentar un caso clinico de una paciente con amenorrea primaria-galactorrea e hiperprolactinemia asociada al síndrome de Silla Turca Vada (SSTV). Metodos: Se presentan los hallazgos clínicos, radiológicos y de laboratorio y se hace revisión de la literatura. Resultados: Paciente femenina de 16 años evaluada por amenorrea primaria y galactorrea, con desarrollo normal de caracteres sexuales secundarios a los 12 años y desarrollo esquelético normal. Los resultados de laboratorio fueron consistentes con hipogonadismo hipogonadotrópico, función tiro idea y adrenal normal y valores elevados de prolactina. La exploración neuroradiológica (Resonancia Magnética, Neumoencefalografia) revelo una silla turcavada, quiste aracnoideo con 60% de ocupación de la fosa sellar, glandula hipofisiaria lateralizada a la derecha con características normales. Después del tratamiento con Bromocriptina (5 mg/dia), la concentración serica se redujo seguido del inicio de menstruadones espontaneas y regulares. Conclusion: El SSTVen la edad prepuberal puede estar asociado con hiperprolactinemia y amenorrea primaria.

ABSTRACT

Objective: To report a case of primary amenorreagalactorrhea and hyperprolactinemia associated to Empty Sella Turcica syndrome. Methods: Clinical, neuroradiologic and laboratory findings are presented and the literature is reviewed. Results: A16-year-old female adolescent was evaluated for primary amenorrhea, galactorrhea. Secondary sex characters were present at 12 years old with normal physical growth. Laboratory findings were consistent with hypogonadotropic hypogonadism, normal thyroid and adrenal function and high plasma levels of prolactin.Pneumoencephalography and magnetic resonance imaging revealed primary empty sella syndrome; the sella turcica was occupied by a 60% arachnoid cyst and a pituitary gland partially flattened at the right side of the sella turcica. After initiation ofbromocriptine therapy (5mg/ day), the serum prolactin level was reduced, followed by spontaneous and regular menses. Conclusion: The empty sella syndrome turcica in prepuberal girls may be associated with hyperprolactinemia and primary amenorrhea-galactorrhea.